Abstract | BACKGROUND: AIMS: PATIENTS AND METHODS: Thirty patients with biliary-type pain complying with the Rome diagnostic criteria of sphincter of Oddi dysfunction and belonging to biliary group I and II were subjected to clinical evaluation, choledochoscintigraphic assessment of the hepatic hilum-duodenum transit time, endoscopic retrograde cholangiopancreatography, and perendoscopic manometry. Twenty two biliary group I and II patients with prolonged hepatic hilum-duodenum transit times were invited to undergo sphincterotomy. Fourteen patients underwent sphincterotomy; eight refused. Clinical and scintigraphic assessments were performed at follow up. RESULTS: Hepatic hilum-duodenum transit time was delayed in all patients with manometric evidence of sphincter of Oddi dysfunction, in all biliary group I patients and in 64% of biliary group II patients. At follow up, all patients who underwent sphincterotomy were symptom free and hepatic hilum-duodenum transit time had either normalised or significantly improved. A favourable post sphincterotomy outcome was predicted in 93% of cases at choledochoscintigraphy and in 57% at manometry. CONCLUSIONS: Quantitative choledochoscintigraphy is a useful and non-invasive test to diagnose sphincter of Oddi dysfunction as well as a reliable predictor of sphincterotomy outcome in post cholecystectomy biliary group I and II patients, irrespective of clinical classification and manometric findings.
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Authors | M Cicala, F I Habib, P Vavassori, N Pallotta, O Schillaci, G Costamagna, M P L Guarino, F Scopinaro, F Fiocca, A Torsoli, E Corazziari |
Journal | Gut
(Gut)
Vol. 50
Issue 5
Pg. 665-8
(May 2002)
ISSN: 0017-5749 [Print] England |
PMID | 11950813
(Publication Type: Comparative Study, Evaluation Study, Journal Article)
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Chemical References |
- Technetium Tc 99m Lidofenin
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Topics |
- Adult
- Aged
- Bile
(metabolism)
- Cholecystectomy
(adverse effects)
- Common Bile Duct Diseases
(diagnosis, etiology, surgery)
- Female
- Follow-Up Studies
- Humans
- Male
- Manometry
- Middle Aged
- Prognosis
- Radionuclide Imaging
- Sphincter of Oddi
(diagnostic imaging, physiopathology, surgery)
- Sphincterotomy, Endoscopic
- Technetium Tc 99m Lidofenin
- Treatment Outcome
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